Artificial Pancreas and Closed Loop Control – is it really that far off?

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For many years academic researchers and device companies alike have investigated, developed and studied that artificial pancreas.   The system isn’t really a pancreas per se but rather a multi-component system that  continuously measures glucose (via a subcutaneous sensor), uses a computerized closed loop controller to determine the proper insulin infusion rate and and then automatically adjusts insulin delivery via a subcutaneous insulin pump.

Many of these automatic feedback control systems are in clinical trials and there has been enthusiasm generated by NIH and JDRF sponsored research in this field.

I don’t think the artificial pancreas is far off at all, although the first generation may not be the fully automated high performing system that we dream about.  Insulin pumps are reliable and sophisticated control systems have been developed that optimize insulin delivery decisions using a personalized predictive model (i.e., determines future glucose response via an adaptive nonlinear PK/PD equation).   The weak link, in my opinion, is the glucose sensing system.  Continuous glucose monitors have improved but may not be at the point were tight glycemic control is possible.  However, some level of autonomous action does seem feasible – today.

 

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